Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jennifer L Petersen, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1558669523

Mrs. Jennifer L Petersen, CCC-SLP is a Speech-Language Pathologist in Middletown, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2011
What do these letters mean?
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

53 Bedford Ave
Middletown, NY 10940-6414
Phone: (845) 326-1784
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 020216-1 (NY)

Record details

NPI number1558669523
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorYes
NPI enumeratedMarch 1, 2011
Last updated in NPPESMarch 1, 2011

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